Prashant Yadav - Academia.edu (original) (raw)

Papers by Prashant Yadav

Research paper thumbnail of Data, analytical techniques and collaboration between researchers and practitioners in humanitarian health supply chains: a challenging but necessary way forward

Journal of Humanitarian Logistics and Supply Chain Management

Purpose This paper aims to provide a discussion on the interface and interactions between data, a... more Purpose This paper aims to provide a discussion on the interface and interactions between data, analytical techniques and impactful research in humanitarian health supply chains. New techniques for data capturing, processing and analytics, such as big data, blockchain technology and artificial intelligence, are increasingly put forward as potential “game changers” in the humanitarian field. Yet while they have potential to improve data analytics in the future, larger data sets and quantification per se are no “silver bullet” for complex and wicked problems in humanitarian health settings. Humanitarian health supply chains provide health care and medical aid to the most vulnerable in development and disaster relief settings alike. Unlike commercial supply chains, they often lack resources and long-term collaborations to enable learning from the past and to improve further. Design/methodology/approach Based on a combination of the authors’ research experience, interactions with practi...

Research paper thumbnail of An inventory reservation problem with nesting and fill rate-based performance measures

International Journal of Production Economics, 2011

Research paper thumbnail of Correcting COVID-19 vaccine misinformation

Research paper thumbnail of Global public health security and justice for vaccines and therapeutics in the COVID-19 pandemic

EClinicalMedicine, 2021

Commission for COVID-19 task force is shaping recommendations to achieve vaccine and therapeutics... more Commission for COVID-19 task force is shaping recommendations to achieve vaccine and therapeutics access, justice, and equity. This includes ensuring safety and effectiveness harmonized through robust systems of global pharmacovigilance and surveillance. Global production requires expanding support for development, manufacture, testing, and distribution of vaccines and therapeutics to low-and middle-income countries (LMICs). Global intellectual property rules must not stand in the way of research, production, technology transfer, or equitable access to essential health tools, and in context of pandemics to achieve increased manufacturing without discouraging innovation. Global governance around product quality requires channelling widely distributed vaccines through WHO prequalification (PQ)/emergency use listing (EUL) mechanisms and greater use of national regulatory authorities. A World Health Assembly (WHA) resolution would facilitate improvements and consistency in quality control and assurances. Global health systems require implementing steps to strengthen national systems for controlling COVID-19 and for influenza vaccinations for adults including pregnant and lactating women. A collaborative research network should strive to establish open access databases for bioinformatic analyses, together with programs directed at human capacity utilization and strengthening. Combating anti-science recognizes the urgency for countermeasures to

Research paper thumbnail of Childhood cancer medicines: understanding barriers to access

The Lancet Global Health, 2021

Research paper thumbnail of Optimal Supply Chain Structure for Distributing Essential Drugs in Low Income Countries: Results from a Randomized Experiment

SSRN Electronic Journal, 2015

Despite increased investments in health commodity procurement, the availability of essential medi... more Despite increased investments in health commodity procurement, the availability of essential medicines at health facilities remains very low in many low and middle income countries. The lack of a wellfunctioning supply chain for essential medicines is often the cause of this poor availability. Using a randomized experiment conducted in over 400 health facilities and 24 districts in Zambia, this study helps understand the optimal supply chain structure for essential medicines distribution in the public sector in low income countries. It focuses on the availability of 15 essential medicines at the health facility level and compares between a cross-dock based two-tier distribution network and a three-tier network. The study shows that a two-tier "cross-dock" like system outperforms a traditional three-tier drug distribution system due to better information flow and better management accountability even though stock is positioned closer to the health facilities in the three-tier system. Results from the study advance existing knowledge in the area of public sector distribution system design in general and drug distribution systems in developing countries in particular.

Research paper thumbnail of National Drug Stockout Risks in Africa: Analysis of the Global Fund Disbursement Process for Procurement from 2002 to 20133

SSRN Electronic Journal, 2014

Despite substantial financial aid from international donors for procurement of health products, s... more Despite substantial financial aid from international donors for procurement of health products, stockouts of life-saving drugs related to prevalent infectious diseases are still widespread in Africa. Addressing the lack of research on why these stockouts occur, we study the relationship between The Global Fund to

Research paper thumbnail of Interventions for an Artemisinin-Based Malaria Medicine Supply Chain

SSRN Electronic Journal, 2014

A rtemisinin combination therapy, the most effective malaria treatment today, is manufactured fro... more A rtemisinin combination therapy, the most effective malaria treatment today, is manufactured from an agriculturally derived starting material Artemisia annua. Artemisinin, the main ingredient in malaria medicines, is extracted from Artemisia leaves and used in the production of medicine for treating malaria. The artemisinin market has witnessed high volatility in the supply and price of artemisinin extract. A large fraction of malaria medicines for endemic countries in sub-Saharan Africa is financed by the Global Fund to Fight AIDS, TB, and Malaria and the US President's Malaria Initiative. These agencies together with the World Health Organization, UNITAID, the United Kingdom Department for International Development and the Bill and Melinda Gates Foundation are exploring ways to increase the level of artemisinin production, reduce volatility of artemisinin prices, and improve overall access to malaria medicines for the population. We develop a model of the supply chain, calibrate the model using field data, and investigate the impact of various interventions. Our model shows that initiatives aimed at improving average yield, creating a support-price for agricultural artemisinin, and a larger and carefully managed supply of semi-synthetic artemisinin have the greatest potential for improving supply and reducing price volatility of artemisinin-based malaria medicine.

Research paper thumbnail of Tuberculosis

Disease Control Priorities, Third Edition (Volume 6): Major Infectious Diseases, 2017

Indoor air pollution 1.4 Low body mass index 2.45 a Alcohol use (daily or alcohol use disorder) 2... more Indoor air pollution 1.4 Low body mass index 2.45 a Alcohol use (daily or alcohol use disorder) 2.94 Diabetes mellitus 3.11 Source: International Institute for Population Sciences and Macro International 2007. Note: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) does not appear in the table because once it was clear that HIV/AIDS was a major risk factor for TB, it became unethical to do a prospective study that did not offer HIV-positive patients isoniazid. a. Odds of tuberculosis for body mass index of 18.5 compared to 25.

Research paper thumbnail of Always Cola, Rarely Essential Medicines: Comparing Medicine and Consumer Product Supply Chains in the Developing World

SSRN Electronic Journal, 2010

The World Health Organization estimates that almost a third of the world's population still lacks... more The World Health Organization estimates that almost a third of the world's population still lacks access to essential medicines. The distribution network for medicines is ineffective and inefficient in many developing countries. Discussions often centre on why the medicines supply chain cannot replicate the supply chain for consumer products and beverages. There is little understanding of the similarities and differences between the two supply chains. This article compares these two supply chains in developing countries from a structural and incentive perspective. It illustrates the complexity of medicine supply chains, and highlights the important differences between these and consumer beverage (soft drink) supply chains.

Research paper thumbnail of Countering Drug Resistance in the Developing World: An Assessment of Incentives Across the Value Chain and Recommendations for Policy Intervention

SSRN Electronic Journal, 2009

Research paper thumbnail of Global Health Forecasting Working Group Background Paper Mapping and Realigning Incentives in the Global Health Supply Chain

Poor allocation of risks among the constituents of a supply chain results in a misalignment of in... more Poor allocation of risks among the constituents of a supply chain results in a misalignment of incentives, leading to over-reactions, unnecessary interventions, second guessing, mistrust, and distorted information – ultimately degrading its ability to match supply and demand. This study assesses the current allocation of operational risks and their impact on the incentives of different players in the global health supply chain, focusing on the case of fixed-dose artemisinin-based combination therapy for malaria as an illustrative example. Currently, there is a highly non-optimal allocation of risks in this supply chain, where constituents that have the best knowledge about demand uncertainty, or the highest ability to resolve part of this uncertainty, or have the highest potential to benefit from this uncertainty reduction, do not necessarily carry its corresponding risks. This and other improper risk allocations lead to misaligned incentives for accurate forecasting, sharing demand...

Research paper thumbnail of Inventory Management Practices in Private Healthcare Facilities in Nairobi County

Production and Operations Management

Universal health coverage (UHC) is an integral part of the United Nations’ sustainable developmen... more Universal health coverage (UHC) is an integral part of the United Nations’ sustainable development goals. The private sector plays a prominent role in achieving UHC, being the primary source of essential medicines for many people. However, many private healthcare facilities in low- and middle-income countries (LMICs) have insufficient stocks of essential medicines. At the same time, we find that these same facilities carry excessive quantities of certain drugs, leading to losses due to obsolescence. This suggests poor inventory control. To propose potential remedies, it is key to fully understand the underlying causes. In semi- structured interviews with facility managers from private healthcare facilities in Nairobi we asked them about their 1) inventory control systems, 2) inventory control skills, 3) time/human resource constraints, 4) budget constraints, 5) motivations for inventory control, and 6) suppliers. Our results show that the problems are strongly driven by resource limitations (budget and time/human resources), managerial issues (relating to skills and systems), and market mechanisms that limit overage and underage costs. Unavailability at the supplier level, and motivations for inventory control, are only minor issues. We argue that these key causes are strongly interlinked and stem from deeper issues in the market and regulatory environment. Our results challenge several prevalent beliefs about medicine supply chains in LMICs and lead to hypotheses that require further testing. We also discuss how such testing could improve our understanding of inventory management in private healthcare facilities and aid progress in achieving UHC.

Research paper thumbnail of Beyond the jab: A need for global coordination of pharmacovigilance for COVID-19 vaccine deployment

Research paper thumbnail of Achieving global equity for COVID-19 vaccines: Stronger international partnerships and greater advocacy and solidarity are needed

PLOS Medicine

Peter Figueroa and co-authors advocate for equity in the worldwide provision of COVID-19 vaccines.

Research paper thumbnail of Operation Warp Speed: implications for global vaccine security

Research paper thumbnail of Urgent needs of low-income and middle-income countries for COVID-19 vaccines and therapeutics

Research paper thumbnail of Incentivizing Capacity Investments for Global Health Products

SSRN Electronic Journal

We study mechanisms that encourage manufacturers of global health products to build production ca... more We study mechanisms that encourage manufacturers of global health products to build production capacity. This is particularly important for health products manufactured for low- and middle-income country (LMIC) markets where willingness to pay is lower and demand risks are greater. As a result, manufacturers can be hesitant to invest to serve these markets at an affordable price for those in need. Development finance institutions and philanthropies are beginning to utilize new instruments to incentivize production/distribution for LMIC markets. The goal of this paper is to understand the effectiveness of such mechanisms in different settings, and to translate our understanding into a framework to guide social investors. We examine four instruments – sales subsidy, capacity subsidy, low interest (concessional) loan, and volume guarantee – and obtain the following results: A capacity subsidy is less costly than a sales subsidy, but a sales subsidy is viable at lower levels of capacity and is less susceptible to moral hazard. A concessional loan has a payment structure similar to a capacity subsidy but has an important difference: while manufacturer savings and social investor cost are the same under a capacity subsidy, these values are linked to the costs of capital under a concessional loan and can be substantially different. A volume guarantee targets manufacturer’s risk rather than relying on the manufacturer’s private cost information. It becomes especially attractive in settings where the social investor has a more favorable and accurate view of the market and where uncertainty around the manufacturer’s cost structure is high.

Research paper thumbnail of Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies

JAMA Health Forum

Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across t... more Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across the US have reported substantial personal protective equipment (PPE) shortages, compromising their ability to keep health care professionals safe while treating increasing numbers of patients. 1 Gloves, face masks, N95 respirators, powered air-purifying respirators, eye protection, and gowns are central to transmission-based precautions. Initial delays in COVID-19 testing increased PPE use, further intensifying demand. Consequently, some health care professionals have resorted to directly sourcing PPE from personal networks. Infection prevention teams across the country have focused on supply conservation with extended use and reuse protocols. These teams have also collaborated with others (engineers, the maker community, local businesses, and community volunteers) to create new forms of PPE, including respirators and eye protection. At the same time, reports suggest there are overseas suppliers with sizable quantities of PPE who want to supply US health care systems, but logistic issues related to quality, payment terms, and air cargo capacity are among the barriers.

Research paper thumbnail of Value-based tiered pricing for universal health coverage: an idea worth revisiting

Gates Open Research

The pricing of medicines and health products ranks among the most hotly debated topics in health ... more The pricing of medicines and health products ranks among the most hotly debated topics in health policy, generating controversy in richer and poorer markets alike. Creating the right pricing structure for pharmaceuticals and other healthcare products is particularly important for low- and middle-income countries, where pharmaceuticals account for a significant portion of total health expenditure; high medicine prices therefore threaten the feasibility and sustainability of nascent schemes for universal health coverage (UHC). We argue that a strategic system of value-based tiered pricing (VBTP), wherein each country would pay a price for each health product commensurate with the local value it provides, could improve access, enhance efficiency, and empower countries to negotiate with product manufacturers. This paper attempts to further understanding on the potential value of tiered pricing, barriers to its implementation, and potential strategies to overcome those.

Research paper thumbnail of Data, analytical techniques and collaboration between researchers and practitioners in humanitarian health supply chains: a challenging but necessary way forward

Journal of Humanitarian Logistics and Supply Chain Management

Purpose This paper aims to provide a discussion on the interface and interactions between data, a... more Purpose This paper aims to provide a discussion on the interface and interactions between data, analytical techniques and impactful research in humanitarian health supply chains. New techniques for data capturing, processing and analytics, such as big data, blockchain technology and artificial intelligence, are increasingly put forward as potential “game changers” in the humanitarian field. Yet while they have potential to improve data analytics in the future, larger data sets and quantification per se are no “silver bullet” for complex and wicked problems in humanitarian health settings. Humanitarian health supply chains provide health care and medical aid to the most vulnerable in development and disaster relief settings alike. Unlike commercial supply chains, they often lack resources and long-term collaborations to enable learning from the past and to improve further. Design/methodology/approach Based on a combination of the authors’ research experience, interactions with practi...

Research paper thumbnail of An inventory reservation problem with nesting and fill rate-based performance measures

International Journal of Production Economics, 2011

Research paper thumbnail of Correcting COVID-19 vaccine misinformation

Research paper thumbnail of Global public health security and justice for vaccines and therapeutics in the COVID-19 pandemic

EClinicalMedicine, 2021

Commission for COVID-19 task force is shaping recommendations to achieve vaccine and therapeutics... more Commission for COVID-19 task force is shaping recommendations to achieve vaccine and therapeutics access, justice, and equity. This includes ensuring safety and effectiveness harmonized through robust systems of global pharmacovigilance and surveillance. Global production requires expanding support for development, manufacture, testing, and distribution of vaccines and therapeutics to low-and middle-income countries (LMICs). Global intellectual property rules must not stand in the way of research, production, technology transfer, or equitable access to essential health tools, and in context of pandemics to achieve increased manufacturing without discouraging innovation. Global governance around product quality requires channelling widely distributed vaccines through WHO prequalification (PQ)/emergency use listing (EUL) mechanisms and greater use of national regulatory authorities. A World Health Assembly (WHA) resolution would facilitate improvements and consistency in quality control and assurances. Global health systems require implementing steps to strengthen national systems for controlling COVID-19 and for influenza vaccinations for adults including pregnant and lactating women. A collaborative research network should strive to establish open access databases for bioinformatic analyses, together with programs directed at human capacity utilization and strengthening. Combating anti-science recognizes the urgency for countermeasures to

Research paper thumbnail of Childhood cancer medicines: understanding barriers to access

The Lancet Global Health, 2021

Research paper thumbnail of Optimal Supply Chain Structure for Distributing Essential Drugs in Low Income Countries: Results from a Randomized Experiment

SSRN Electronic Journal, 2015

Despite increased investments in health commodity procurement, the availability of essential medi... more Despite increased investments in health commodity procurement, the availability of essential medicines at health facilities remains very low in many low and middle income countries. The lack of a wellfunctioning supply chain for essential medicines is often the cause of this poor availability. Using a randomized experiment conducted in over 400 health facilities and 24 districts in Zambia, this study helps understand the optimal supply chain structure for essential medicines distribution in the public sector in low income countries. It focuses on the availability of 15 essential medicines at the health facility level and compares between a cross-dock based two-tier distribution network and a three-tier network. The study shows that a two-tier "cross-dock" like system outperforms a traditional three-tier drug distribution system due to better information flow and better management accountability even though stock is positioned closer to the health facilities in the three-tier system. Results from the study advance existing knowledge in the area of public sector distribution system design in general and drug distribution systems in developing countries in particular.

Research paper thumbnail of National Drug Stockout Risks in Africa: Analysis of the Global Fund Disbursement Process for Procurement from 2002 to 20133

SSRN Electronic Journal, 2014

Despite substantial financial aid from international donors for procurement of health products, s... more Despite substantial financial aid from international donors for procurement of health products, stockouts of life-saving drugs related to prevalent infectious diseases are still widespread in Africa. Addressing the lack of research on why these stockouts occur, we study the relationship between The Global Fund to

Research paper thumbnail of Interventions for an Artemisinin-Based Malaria Medicine Supply Chain

SSRN Electronic Journal, 2014

A rtemisinin combination therapy, the most effective malaria treatment today, is manufactured fro... more A rtemisinin combination therapy, the most effective malaria treatment today, is manufactured from an agriculturally derived starting material Artemisia annua. Artemisinin, the main ingredient in malaria medicines, is extracted from Artemisia leaves and used in the production of medicine for treating malaria. The artemisinin market has witnessed high volatility in the supply and price of artemisinin extract. A large fraction of malaria medicines for endemic countries in sub-Saharan Africa is financed by the Global Fund to Fight AIDS, TB, and Malaria and the US President's Malaria Initiative. These agencies together with the World Health Organization, UNITAID, the United Kingdom Department for International Development and the Bill and Melinda Gates Foundation are exploring ways to increase the level of artemisinin production, reduce volatility of artemisinin prices, and improve overall access to malaria medicines for the population. We develop a model of the supply chain, calibrate the model using field data, and investigate the impact of various interventions. Our model shows that initiatives aimed at improving average yield, creating a support-price for agricultural artemisinin, and a larger and carefully managed supply of semi-synthetic artemisinin have the greatest potential for improving supply and reducing price volatility of artemisinin-based malaria medicine.

Research paper thumbnail of Tuberculosis

Disease Control Priorities, Third Edition (Volume 6): Major Infectious Diseases, 2017

Indoor air pollution 1.4 Low body mass index 2.45 a Alcohol use (daily or alcohol use disorder) 2... more Indoor air pollution 1.4 Low body mass index 2.45 a Alcohol use (daily or alcohol use disorder) 2.94 Diabetes mellitus 3.11 Source: International Institute for Population Sciences and Macro International 2007. Note: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) does not appear in the table because once it was clear that HIV/AIDS was a major risk factor for TB, it became unethical to do a prospective study that did not offer HIV-positive patients isoniazid. a. Odds of tuberculosis for body mass index of 18.5 compared to 25.

Research paper thumbnail of Always Cola, Rarely Essential Medicines: Comparing Medicine and Consumer Product Supply Chains in the Developing World

SSRN Electronic Journal, 2010

The World Health Organization estimates that almost a third of the world's population still lacks... more The World Health Organization estimates that almost a third of the world's population still lacks access to essential medicines. The distribution network for medicines is ineffective and inefficient in many developing countries. Discussions often centre on why the medicines supply chain cannot replicate the supply chain for consumer products and beverages. There is little understanding of the similarities and differences between the two supply chains. This article compares these two supply chains in developing countries from a structural and incentive perspective. It illustrates the complexity of medicine supply chains, and highlights the important differences between these and consumer beverage (soft drink) supply chains.

Research paper thumbnail of Countering Drug Resistance in the Developing World: An Assessment of Incentives Across the Value Chain and Recommendations for Policy Intervention

SSRN Electronic Journal, 2009

Research paper thumbnail of Global Health Forecasting Working Group Background Paper Mapping and Realigning Incentives in the Global Health Supply Chain

Poor allocation of risks among the constituents of a supply chain results in a misalignment of in... more Poor allocation of risks among the constituents of a supply chain results in a misalignment of incentives, leading to over-reactions, unnecessary interventions, second guessing, mistrust, and distorted information – ultimately degrading its ability to match supply and demand. This study assesses the current allocation of operational risks and their impact on the incentives of different players in the global health supply chain, focusing on the case of fixed-dose artemisinin-based combination therapy for malaria as an illustrative example. Currently, there is a highly non-optimal allocation of risks in this supply chain, where constituents that have the best knowledge about demand uncertainty, or the highest ability to resolve part of this uncertainty, or have the highest potential to benefit from this uncertainty reduction, do not necessarily carry its corresponding risks. This and other improper risk allocations lead to misaligned incentives for accurate forecasting, sharing demand...

Research paper thumbnail of Inventory Management Practices in Private Healthcare Facilities in Nairobi County

Production and Operations Management

Universal health coverage (UHC) is an integral part of the United Nations’ sustainable developmen... more Universal health coverage (UHC) is an integral part of the United Nations’ sustainable development goals. The private sector plays a prominent role in achieving UHC, being the primary source of essential medicines for many people. However, many private healthcare facilities in low- and middle-income countries (LMICs) have insufficient stocks of essential medicines. At the same time, we find that these same facilities carry excessive quantities of certain drugs, leading to losses due to obsolescence. This suggests poor inventory control. To propose potential remedies, it is key to fully understand the underlying causes. In semi- structured interviews with facility managers from private healthcare facilities in Nairobi we asked them about their 1) inventory control systems, 2) inventory control skills, 3) time/human resource constraints, 4) budget constraints, 5) motivations for inventory control, and 6) suppliers. Our results show that the problems are strongly driven by resource limitations (budget and time/human resources), managerial issues (relating to skills and systems), and market mechanisms that limit overage and underage costs. Unavailability at the supplier level, and motivations for inventory control, are only minor issues. We argue that these key causes are strongly interlinked and stem from deeper issues in the market and regulatory environment. Our results challenge several prevalent beliefs about medicine supply chains in LMICs and lead to hypotheses that require further testing. We also discuss how such testing could improve our understanding of inventory management in private healthcare facilities and aid progress in achieving UHC.

Research paper thumbnail of Beyond the jab: A need for global coordination of pharmacovigilance for COVID-19 vaccine deployment

Research paper thumbnail of Achieving global equity for COVID-19 vaccines: Stronger international partnerships and greater advocacy and solidarity are needed

PLOS Medicine

Peter Figueroa and co-authors advocate for equity in the worldwide provision of COVID-19 vaccines.

Research paper thumbnail of Operation Warp Speed: implications for global vaccine security

Research paper thumbnail of Urgent needs of low-income and middle-income countries for COVID-19 vaccines and therapeutics

Research paper thumbnail of Incentivizing Capacity Investments for Global Health Products

SSRN Electronic Journal

We study mechanisms that encourage manufacturers of global health products to build production ca... more We study mechanisms that encourage manufacturers of global health products to build production capacity. This is particularly important for health products manufactured for low- and middle-income country (LMIC) markets where willingness to pay is lower and demand risks are greater. As a result, manufacturers can be hesitant to invest to serve these markets at an affordable price for those in need. Development finance institutions and philanthropies are beginning to utilize new instruments to incentivize production/distribution for LMIC markets. The goal of this paper is to understand the effectiveness of such mechanisms in different settings, and to translate our understanding into a framework to guide social investors. We examine four instruments – sales subsidy, capacity subsidy, low interest (concessional) loan, and volume guarantee – and obtain the following results: A capacity subsidy is less costly than a sales subsidy, but a sales subsidy is viable at lower levels of capacity and is less susceptible to moral hazard. A concessional loan has a payment structure similar to a capacity subsidy but has an important difference: while manufacturer savings and social investor cost are the same under a capacity subsidy, these values are linked to the costs of capital under a concessional loan and can be substantially different. A volume guarantee targets manufacturer’s risk rather than relying on the manufacturer’s private cost information. It becomes especially attractive in settings where the social investor has a more favorable and accurate view of the market and where uncertainty around the manufacturer’s cost structure is high.

Research paper thumbnail of Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies

JAMA Health Forum

Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across t... more Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across the US have reported substantial personal protective equipment (PPE) shortages, compromising their ability to keep health care professionals safe while treating increasing numbers of patients. 1 Gloves, face masks, N95 respirators, powered air-purifying respirators, eye protection, and gowns are central to transmission-based precautions. Initial delays in COVID-19 testing increased PPE use, further intensifying demand. Consequently, some health care professionals have resorted to directly sourcing PPE from personal networks. Infection prevention teams across the country have focused on supply conservation with extended use and reuse protocols. These teams have also collaborated with others (engineers, the maker community, local businesses, and community volunteers) to create new forms of PPE, including respirators and eye protection. At the same time, reports suggest there are overseas suppliers with sizable quantities of PPE who want to supply US health care systems, but logistic issues related to quality, payment terms, and air cargo capacity are among the barriers.

Research paper thumbnail of Value-based tiered pricing for universal health coverage: an idea worth revisiting

Gates Open Research

The pricing of medicines and health products ranks among the most hotly debated topics in health ... more The pricing of medicines and health products ranks among the most hotly debated topics in health policy, generating controversy in richer and poorer markets alike. Creating the right pricing structure for pharmaceuticals and other healthcare products is particularly important for low- and middle-income countries, where pharmaceuticals account for a significant portion of total health expenditure; high medicine prices therefore threaten the feasibility and sustainability of nascent schemes for universal health coverage (UHC). We argue that a strategic system of value-based tiered pricing (VBTP), wherein each country would pay a price for each health product commensurate with the local value it provides, could improve access, enhance efficiency, and empower countries to negotiate with product manufacturers. This paper attempts to further understanding on the potential value of tiered pricing, barriers to its implementation, and potential strategies to overcome those.